Radical Cystectomy for Carcinoma of the Bladder: 2,720 Consecutive Cases 5 Years Later

Abstract

Contemporary cystectomy can be performed with minimal mortality. Radical cystectomy for organ confined disease is followed by good therapeutic results and enhances the possibilities for functional restoration. With stage progression there is a stepwise reduction in survival probability. The radical operation can provide disease-free survival for an important subgroup of node positive cases (27.3%). Additional therapy is needed to improve the oncological outcome for advanced locoregional disease.

Survival of patients with bladder cancer after radical cystectomy

“…Рак мочевого пузыря щепринятым является тот факт, что задержка оператив-ного вмешательства ведет к прогрессированию стадии РМП и ухудшению прогноза. Задержка выполнения РЦЭ более чем на 12 нед после установления диагноза определятся как критический период, после которого прогноз существенно ухудшается [20]. Частота метастатического поражения регионарных ЛУ находится в диапазоне от 18 до 24 % [4,8,10,15].…”

“…По данным раз-личных исследователей, билатеральная лимфаденэкто-мия до середины общих подвздошных артерий является достаточной и обеспечивает удаление 20 ЛУ [4,7,8,20]. Мы также считаем, что диссекция 20 ЛУ обеспечивает качественную и достаточную лимфаденэктомию.…”

Deep Venous Thrombosis After Radical Pelvic Surgery

“…Patients undergoing large bowel surgery also have a considerable risk of DVT and pulmonary embolism. The incidence of DVT following radical cystectomy in our hospital is 2% to 2.6% and PE following DVT or without prior DVT has long been a leading cause of post-operative death (Ali-El-Dein et al, 2008;Ghoneim et al, 2008). In patients undergoing surgery or radiotherapy for treatment of localized prostate cancer the incidence of DVT was 2% for pelvic lymphadenectomy alone and 1.9% following prostatectomy, while fatal PE occurred in 2 patients (3.7%) after prostatectomy (Bratt et al, 1994).…”

“…The incidence of DVT may be as low 2% after radical cystectomy (Ali-El-Dein et al, 2008;Ghoneim et al, 2008), or as high as 40% following prolonged gynecological or obstetrical surgery (Walsh et al, 1974;Clarke-Pearson et al, 1983). Patients undergoing large bowel surgery also have a considerable risk of DVT and pulmonary embolism.…”

Intra-arterial Combination Chemotherapy with Maximum Transurethral Resection of Bladder Tumour for T1 Grade 3 and T2--3N0M0 Bladder Cancers

“…Survival outcome following radical cystectomy has gradually improved with more modern techniques (e.g. the mortality rate for extended lymphadenectomy) has decreased by 50% over the past 20 years [3][4][5][6]. On the other hand, around 15% of patients with muscle-invasive bladder cancer had no residual tumour following radical cystectomy on pathological examination.…”